Leadership Bourbon County Application

Leadership Bourbon County Application

Class of 2025
You are taking the first step toward discovering your community! We wish everyone could join us, but space is limited. This application helps us determine who's ready to commit to the program. Leadership Bourbon County is open to anyone who lives and/or works in the county. Selection is determined without regard to race, color, religion, sexual orientation, sex or national origin.

Those interested in applying must be able to commit their time to the overnight orientation April 21st & 22nd at Mustard Seed Hill. Class members are also required to attend 6 out of the 8 day sessions (including orientation April 21st/22nd) in order to graduate from the program.

Deadline to apply is March 31, 2025.

Please contact the Paris-Bourbon County Chamber of Commerce with any questions at 859-987-3205 or chamber@parisky.com
Your Contact Information
Last Name
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Cell Phone
Where do you work?
Supervisor name
How long have you worked here?
Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work Phone
Letter of recommendation from Supervisor and approval of time off.

Cancelof
How long have you lived and/or worked in Bourbon County?
Leadership Bourbon County will award one full-tuition scholarships for this year's program. Will you need financial assistance to attend Leadership Bourbon County?

NoYes
Your Education & Employment

	Name of School	Location	Dates Attended	Degree	Major
1.
2.
3.
4.

Academic extracurricular activities, special honors, awards for leadership activities. List your community, civic, professional, religious, social, athletic, or other organization activities.
Employment / Work History

	Employer	Title or Responsibilities	Date From	Date to
1.
2.
3.
4.

Present Title
Brief description of job and main responsibilities:
**To meet graduation requirements you must attend six out of eight day sessions. The overnight orientation on April 21-22, 2025 is also mandatory. Must be approved by employer.
Are you and your employer willing to commit your time to attending at least six full-day sessions and the overnight orientation?

YesNo
Strengths and Weaknesses
What do you consider your highest responsibility, skill or achievement? Career or Personal
What would you list as your greatest strength(s)?
Where do you have room for improvement?
Your Organizations and Activities

Please list in order of importance to you up five community, civic, professional, religious, social, athletic, and other organizations in which you have been a member.

	Organization/Activity	Position Held	Date From	Date to
1.
2.
3.
4.
5.

What impact have these organizations and activities (and your participation in them) had on your community, school, friends and/or workplace?
Your Leadership
Do you consider yourself a leader? Why? How?
What do you hope to gain from participation in Leadership Bourbon County?
Name three weaknesses/areas you want to improve when it comes to leadership?
In your opinion, what are the three most prominent opportunities for improvement in our community today? Explain why and provide any recommendations for approaching and resolving these opportunities.
Tell us three unique things about you. (this will be used in an ice breaker game during orientation)
INSERT SCHEDULE HERE....HOW DO YOU INSERT A LINK?

A $50 application fee is required to complete the application

Application fee

$50.00

Total

$0.00

Credit Card

Today's Date

MonthDayYear
Date
Tuition
Tuition for Leadership Bourbon County is $350 which covers all program costs including meals. You, your company, or a sponsor will be billed for this fee by the Paris-Bourbon Chamber of Commerce.

Once we have selected you, you or your company will be billed for payment.
I acknowledge, if selected for Leadership Bourbon County I (or my company/sponsor) am responsible for the $350 tuition.
If I am selected I pledge to devote the time and resources necessary to complete the program
Type your name
Name
Signature

Clear
Should be Empty:

Leadership Bourbon County Application

Those interested in applying must be able to commit their time to the overnight orientation April 21st & 22nd at Mustard Seed Hill. Class members are also required to attend 6 out of the 8 day sessions (including orientation April 21st/22nd) in order to graduate from the program.

Deadline to apply is March 31, 2025.

Please contact the Paris-Bourbon County Chamber of Commerce with any questions at 859-987-3205 or chamber@parisky.com

Your Contact Information

Your Education & Employment

Employment / Work History

Strengths and Weaknesses

Your Organizations and Activities

Your Leadership

Credit Card

Tuition